Ukuqonda i-General Anesthesia
I-anesthesia imithi enikezwe isiguli ukuvimbela ubuhlungu. Kunezinhlobo eziningi ze-anesthesia kanti ezinye zivumela isiguli ukuba siqaphe futhi siqondiswe ngesikhathi senqubo yezokwelapha, kuyilapho ezinye imithi ye-anesthesia inganikezwa ukuvimbela ukuqwashisa ngokwenza isiguli singakwazi lutho ngesikhathi senqubo yezokwelapha.
Uhlobo lwe-anesthesia olusetshenzisiwe lusekelwe esimweni senqubo eyenziwa, iminyaka nobudala besiguli, kanye nezintandokazi zomhlinzeki ohlinzayo nomhlinzeki we-anesthesia.
Ngezinye izinqubo isiguli singakwazi ukukhetha phakathi kwezinhlobo ezahlukene ze-anesthesia kanti abanye bangadinga uhlobo oluthile.
I-General Anesthesia ichazwe
Kunezinhlobo eziningi ze-anesthesia. Uhlobo olulodwa yi-anesthesia ejwayelekile, i-anesthesia eqinile, nohlobo oluvame ukusetshenziswa kakhulu ngesikhathi sokuhlinzwa. Lolu hlobo lwe-anesthesia lwenza isiguli singaphenduli kulokho okuyikho ngokuyinhloko ye-coma etholakalayo ngokwemithi.
I-anesthesia jikelele iyinhlanganisela yemithi ehloselwe ukwenza isiguli singazi ukuthi kwenzekani kuzo, ukuvimbela ubuhlungu, nokukhubazeka umzimba ngesikhathi senqubo. Ejwayele ukusetshenziswa ngesikhathi sokuhlinzwa, i-anesthesia jikelele ivumela udokotela ukuba anikeze ukwelashwa okungaba buhlungu kakhulu uma isiguli siphapheme futhi sikwazi ukuzizwa.
I-anesthesia ejwayelekile ayigcini nje eyenza umuntu angazi, futhi ikhubaza imizimba yomzimba kuhlanganise nemisipha eyenza ikwazi ukuphefumula.
Ngenxa yalesi sizathu, iziguli ezithola i-anesthesia ejwayelekile zifuna i-ventilator ukuba yenze umsebenzi we-diaphragm nezinye izihluthulelo ezisiza ukuba kwenzeke ukuthi zivuselele futhi zifake.
Kungani Kudingeka I-Anesthesia Ejwayelekile?
I-anesthesia ejwayelekile isetshenziselwa ukuhlinzwa okungathí sina, izinqubo ezinde, nezinqubo eziyoba nzima kakhulu.
Lolu hlobo lwe-anesthesia alugcini nje kuphela luvumela isiguli ukuba senze inqubo ngaphandle kobuhlungu, kodwa futhi sivumela isiguli ukuba singazi lutho ngenqubo.
Ngezinye izindlela zokuhlinza, kungaba yingozi kakhulu ukuphaphama ngenqubo, noma ngabe ukwazi ukuzwa ubuhlungu noma cha. Cabanga ukuthi unesidumbu esisusiwe, njengokungathi phakathi kwe-appendectomy ukususa isithasiselo, nokuvuleka okukhulu. Ngenkathi ungase ungaboni ubuhlungu, bekuzoba nzima kakhulu ukubhekana nokuhlinzwa ngenkathi uphapheme futhi uqaphile.
Izingozi ze-General Anesthesia
Izingozi ezihlobene ne-anesthesia ziyahlukahluka kakhulu kusukela enkambisweni kuya enkambisweni, naphakathi kweziguli ezahlukene. Njengoba ungacabanga, isiguli ngasinye sinezinga labo lomngcingo, njengoba kungekho bantu ababili abafana ncamashi. Isibonelo, isiguli esineminyaka engu-90 siyoba nengozi ehlukile ngokuphelele uma sinokuhlinzekwa kwesithasiselo kunesiguli esineminyaka engu-12 ubudala. Nazi ezinye zezingozi ezingenzeka:
- Ukucabangela / ukuhlanza : Lezi ziguli ezivame ukwedlula zonke zibhekene ne-anesthesia jikelele, futhi kulula kakhulu ukuzivimbela kunokwelashwa. Ngenxa yalesi sizathu kubalulekile ukukhuluma ngomlando wesiphithiphithi esibangelwa i-anesthesia ngaphambi kokuhlinzwa.
- Ukuqwashisa kwe-Anesthesia: Lesi yisimo esenzeka lapho isiguli singazi lutho ngokuphelele ngesikhathi se-anesthesia jikelele.
- Umkhuhlane / ukuphazamiseka: Okubangelwa yi-tube yokuphefumula, lokhu kucasuka ngokuvamile kuncane.
- Umlomo omile: Inkinga encane ehamba lapho isiguli sikwazi ukuphuza amanzi.
- Ukuphikisana / ukukhukhuma: Lokhu kuvame ukuhlala isikhathi esifushane ngemuva kokuhlinzwa futhi uyahamba lapho isiguli siphapheme futhi sihamba.
- Ukulala: Lokhu kuvamile emva kokuhlinzwa futhi kuxazulula lapho umzimba ususe imithi eminingi esetshenziselwa i-anesthesia.
- Ama-muscle aches: Okubangelwa yimithi noma ngokulala amanga ngenkathi kwenziwa inqubo, lesi simo ngokuvamile sesikhashana futhi siyahamba phakathi kwamahora noma izinsuku zokuhlinzwa.
- Ukunambitha: Imithi yokwelashwa ivame ukusola ukushaya, kanti le nkinga ngokuvamile iyahamba uma imithi ebuhlungu ingasadingeki.
- Ukudideka: Iziguli ezingase zibe nokudideka ngemva kokuhlinzwa zikhulile, zine-Alzheimer's disease, ukucindezeleka komqondo, noma esinye isimo esibangela ukudideka njalo.
- Kunzima ukuvuthwa / ukuhluleka ukuchama: Lokhu kuvame kakhulu ezigulini ezine-catheter yamanzi ngesikhathi sokuhlinzwa futhi kungathatha amahora noma ngisho nezinsuku ukuze isifiso sibuyele evamile.
- I-Ileus: Lesi yisimo lapho amathumbu engavuki masinyane njengoba kulindeleke ngemuva kokuhlinzwa futhi ukunyakaza kuphuza kakhulu noma kungekho.
- Ukulukhuni ukuphuma ku-ventilator: Ukugcoba kusuka kwendiza kuyinselele kakhulu kwiziguli ezigula kakhulu noma iziguli ezinenkinga yokuphefumula.
- Ukuphefumula / i-pneumonia: Ukugwinya ngokweqile ukudla noma uketshezi ngesikhathi sokuhlinzwa ingozi eyaziwayo yokuhlinzwa futhi isizathu sokudla ngokushesha ngaphambi kokuhlinzwa kuvinjelwe .
- Ama-blood clots: Le nkinga ivame kakhulu ngemva kokuhlinzwa ngoba isiguli sisengesikhathi esidelele, okuyinto eyaziwayo engozini yezindwangu zegazi.
- I-hyperthermia engalungile: Lesi simo esingasongela impilo esibangela ukusabela okunzima ku-anesthesia. Kuvame ukugijima emindenini.
Ezinye izinhlobo ze-Anesthesia
Ngaphambi kokuba unqume ukuthi udinga i-anesthesia jikelele yenqubo yakho, kubalulekile ukwazi izinhlobo ezahlukene ze-anesthesia ezitholakalayo. Izinhlobo ezijwayelekile kakhulu ze-anesthesia, ngaphandle kwe-anesthesia jikelele, zilandelayo:
I-anesthesia yesiFunda : Eyaziwa nangokuthi i-block yesifunda, lolu hlobo lwe-anesthesia luvimbela isiguli ukuba singazwa isifunda somzimba, njengengalo yonke noma ngezansi kwesikhumba.
- I-anesthesia yasendaweni : Lolu hlobo lwe-anesthesia luvimbela ukuzwa endaweni encane yomzimba, njengokungathi uma umunwe uvaliwe ukuze iziqu zingasetshenziswa ukuthunga ukuvalwa.
- Ukunakekela i-anesthesia (MAC) : Lolu hlobo lwe-anesthesia, owaziwa nangokuthi ukulala ebusuku, uhlobo lwe-anesthesia oluvimbela ubuhlungu ngenkathi isiguli siyazi noma sihlezi kancane. Isiguli singase sikhumbule yonke inqubo noma singenakho ukukhumbula izenzakalo.
Phakathi ne-General Anesthesia
Inqubo ye-anesthesia ejwayelekile ngokuvamile iqala nge-sedation, ukwenza kube lula ukufaka ithubhu yokuphefumula. Uhlobo lwe-sedation lushiywa kumhlinzeki we-anesthesia okumele ukhethe, futhi luyahlukahluka ngokuya ngesiguli kanye nohlobo lokuhlinzwa.
Uma isiguli sisendlini yokusebenza, ifakwe kumadivayisi wokuqapha, futhi izivumelwano zokuphepha ziphelile, i-anesthesia ingaqala. Kuyinto evamile ukuthi ngaphambi kokuba kutholakale imithi yokuguqula, "isikhathi sokuphuma" senziwa ukukhomba isiguli kanye nenqubo abayenayo. Lokhu kwenziwa ukuvimbela ukuhlinzwa okungalungile kwesayithi / okungalungile.
Uma isikhathi siphelile sigcwaliswe isiguli singanikezwa imishanguzo yokuyihlalisa futhi umhlinzeki we-anesthesia uqala inqubo yokulungiselela isiguli ngokuhlinzwa.
Intubation and Window Ngesikhathi Esivamile I-Anesthesia
Imisipha yomzimba iphelelwe amandla ngesikhathi se-anesthesia jikelele, kufaka phakathi imisipha esiza amaphaphu athole ukuphefumula, okusho ukuthi amaphaphu akakwazi ukusebenza ngokwabo. Ngenxa yalesi sizathu, kubalulekile ukuthi i- ventilator isetshenziselwe ukuphefumula emaphashini. Ukuze kucace, amaphaphu asebenza ngesikhatsi se-anesthesia, asuke engenakho ikhono lokuphefumula ngoba imisipha eyenza leyo misebenzi ingasebenzi okwesikhashana.
Ukufakwa efenjini kudinga ukuba ithubhu, ebizwa ngokuthi i-endotracheal tube, ingeniswe emoyeni. Le tube itholakala ekubhebhethekeni okukhudlwana okuya ku-ventilator, okuvumela i-ventilator ukuthi ihambise oksijeni kwisiguli. Inqubo yokufaka ithubhu ibizwa ngokuthi i- intubation .
Ukuqapha Ngesikhathi Isikhathi Esijwayelekile Sama-Anesthesia
Ngesikhathi sokuhlinzwa isiguli sihlolisiswa ngokucophelela ngamadivaysi okuqapha ama-computer athola izinga lokushaya kwenhliziyo, inani le-oksijini egazini, inani lokuphefumula isiguli esithathayo, ngisho ne-EKG yesiguli. Ngaphezu kokuqapha kwe-elekthronikhi, isiguli siphinde sihlolwe yi-OR abasebenzi kanye nomhlinzeki we-anesthesia.
I-anesthesia ejwayelekile ihlinzekwa ngokujwayelekile ngudokotela olwazinambuzane, obizwa ngokuthi i-anesthesiologist, noma i- CRNA , umhlengikazi obhalisiwe obhalisiwe obhalisiwe. Bobabili banikeza i-anesthesia ephephile futhi ephumelelayo, futhi banokuhlangenwe nakho okubanzi ekunikezeni i-anesthesia ejwayelekile.
Phakathi nenqubo, umgomo wukuthi isiguli singazi ngokuphelele ukuthi kwenzekani kuzo, kuhlanganise nokungabi nobuhlungu.
Ukuvuka Kusuka Ku-Anesthesia Okuvamile
Ukuthi umuntu uvuka kanjani ku-anesthesia kuncike kuhlobo lokuhlinzwa ababenalo nokuthi baphefumula kangakanani. Umgomo emva kwe-anesthesia jikelele ukukhulisa isiguli-susa ithubhu lokuphefumulela-ngokushesha ngangokunokwenzeka ngemuva kokuhlinzwa.
Izinqubo ezivamile futhi eziyinkimbinkimbi ziphela ngokuphela kwemithi enikezwa ukuthi ivuselela i-anesthesia, ikhuphe isiguli futhi iphele ukukhubazeka kwemisipha. Lezi ziguli ngokuvamile zine tube yokuphefumula isuswe ngokushesha ekupheleni kokuhlinzwa futhi ziphefumula zodwa zingakapheli imizuzu yokuhlinzwa ukuphela. Lezi ziguli zivame ukuvuka e-PACU-post-anesthesia ukunakekelwa kweyunithi-futhi uye esibhedlela esibhedlela noma ubuyele ekhaya uma seziphapheme ngokuphelele.
Kwezinye izindlela zokuhlinzwa ezibucayi, njengokuhlinzwa okuvulekile kwenhliziyo noma ukuhlinzeka ngobuchopho, isiguli sivunyelwe ukuphumula kancane kancane kusuka ku-anesthesia futhi akunikezwa i-agent yokuguqula. Lokhu kusho ukuthi isiguli singase sihlale ku-ventilator amahora angu-6-8 emva kokuhlinzwa futhi sibe nethubhu yokuphefumula isusiwe uma ivukile.
Ezinye iziguli zizohlala zixhomeke emotweni izinsuku noma ngisho nangemva kokuhlinzwa, kodwa lokhu akuvamile. Iziguli ezinezifo zokuphefumula ezenza ukuphefumula kube nzima nakakhulu zingase zibe nobunzima ngokususwa ku-ventilator, njengababhemayo nezigulane ezigqithisayo.
Ukudla nokuphuza emva kwe-Anesthesia
Lapho isiguli siphapheme ngemuva kokuhlinzwa, ngokuvamile bayakwazi ukuncelisa i-ice chips noma bathathe amanzi amancane. Uma lokhu kuhamba kahle, isinyathelo esilandelayo ukuphuza utshwala obuvamile, okulandelwa ukudla okuvamile. Le nqubo ingathatha amahora, noma ngisho nezinsuku uma isiguli sibhekana nesicanucanu, ukuhlanza, noma nje asizizwa sithatha ukudla noma uketshezi.
Ezimweni eziningi, isiguli sikwazi ukudla ukudla okuvamile phakathi nosuku lokuthola i-anesthesia jikelele.
Ukuphepha Emva Kwesibili Anesthesia
I-American Association of Nurse Anesthetics (AANA) yenza izincomo eziningi ngokuphepha kwesiguli emva kokuthola i-anesthesia ejwayelekile. Lokhu kungathatha usuku olugcwele noma isikhathi eside ukuba i-anesthesia iguqulwe ngokuphelele, futhi kuze kube yilapho isenza, isiguli esiphezulu singase sizithole sizizwa silele, sihlaselwe noma sididekile.
Ngosuku lokuqala emva kokuhlinzwa, lindela ukuchitha isikhathi esiningi ukuphumula ngokuthula, ukulala, noma ukwenza imisebenzi yokuphumula. Hlela ukuthatha usuku olulandelayo ngemuva kokuba u-anesthesia jikelele aphume emsebenzini kanye neminye imisebenzi enzima.
Izincomo ze-AANA zihlanganisa ukungasebenzisi imishini enzima-kuhlanganise nokushayela imoto-noma ukusayina noma yimaphi amaphepha omthetho okungenani amahora angu-24 ngemva kokuhlinzwa. Hlela ukuba nomshayeli akuyise ekhaya kusukela esikhungweni sokuhlinza, futhi ugweme ukuphuza utshwala noma ukuthatha imithi yokudambisa engayishiwo udokotela ohlinzayo ngosuku lokuqala emva kokuhlinzwa.
Babuye batusa ukuthi uthole usizo ngokunakekelwa kwabantwana uma unezingane ezincane ekhaya, njengoba uzodinga ukuphumula okungaphezulu kunokujwayelekile okungenani ngosuku ngemuva kokuhlinzwa, mhlawumbe isikhathi eside.
Izwi elivela
I-anesthesia ejwayelekile inezingozi, kodwa imivuzo yokuba nokuhlinzwa mahhala kungaba nobukhulu. Isinqumo sakho sokuhlinzwa kufanele silinganise izingozi zenqubo kanye ne-anesthesia oyothola ngokumelene nemivuzo engaba khona yenqubo. Nakuba kuyiqiniso ukuthi zonke izinhlinzeko zinezingozi, kungase kube nezinzuzo ezinkulu kusuka ekuhlinzekeni. Nguwe kuphela onganquma ukuthi uzimisele yini ukuhlinzwa-ne-anesthesia-uma izinzuzo zizuzisa isikhathi, umzamo, ubuhlungu kanye nobungozi.
> Umthombo:
> Konke Mayelana Ne-Anesthesia. AANA. Kufinyelelwe ngo-Agasti, 2017. http://www.aana.com/forpatients/Pages/All-Abasebenzisi-Anesthesia.aspx